Infant and Young Child Feeding Practices- An Interventional Behaviour Change Communication Approach

Introduction: Infant and young child feeding have the single greatest potential impact on child nutrition and survival. The period between conception and two years is critical in a child's life and this is when interventions to improve nutrition must be delivered. Aim: To determine the impact of a tailored intervention on Infant and Young Child Feeding (IYCF) practices among mothers of children under three years of age and antenatal women. Materials and Methods: An interventional study was carried out among Antenatal women, mothers of children under three years of age and influencers in a self-administration area. The calculated sample size for the primary objectives varied between 30-50. In order to give representation to at least 80% of the panchayat, all such women numbering 351 and 87 for each category from the randomly selected 12 of the 16 wards were enrolled in the study. Knowledge and practice of diet during pregnancy, antenatal check-up, breastfeeding initiation, exclusive breastfeeding, expressed breast milk, complementary food items, consistency and frequency of feeding, hygiene, feeding during illness, dangers of bottle feeding were assessed before intervention. After the intervention, an endline survey was conducted to assess the change in the knowledge and practice of the infant and young child feeding practices. Statistical analysis was carried out by comparison of mean, proportions before and after the study. Mc Nemar's chi-square was done on variables with significant improvement followed by multivariate logistic regression. Results: The mean age of the mothers was 27.42 +/- 4.53 years. There was a significant increase in knowledge with regard to initiation, exclusive breastfeeding (p=0.01, p=0.01) and bottle feeding (p<0.01) among respondents and influencers. About half (47.9%) of the mothers had initiated breastfeeding within 1 hour of birth registering, a marginal increase from 45.2%. Reasons cited for non-initiation (n=187) were caesarean section (84.5%), child in intensive care unit (10.7%), delay in getting baby (2.1%) and no breast milk (1.07%). A significant decline in prelacteal feeds from 28.9% at baseline to 23.4% after the intervention was observed. Regression analysis for the IYCF practices with significant change demonstrated that belonging to a nuclear family was a predictor of improvement in diet of antenatal women; decrease in bottle feeding was a predictor of prelacteal feeds (OR=10.9 95%CI 3.9-29.9, p<0.001) and vice versa. Conclusion: Complex behaviour in relation to IYCF can be successfully addressed through a multisectoral approach; though follow-up is necessary to sustain it.